Organization
ANESTHESIA ASSOC OF NORTHEAST ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK J KNIFFEN M.D. (PRESIDENT)
(708) 915-7318
Entity
Organization
Contact information
Practice address
6701 159TH ST, INGALLS SAME DAY SURGERY, TINLEY PARK, IL 60477-1758
(708) 915-7318
(708) 429-0220
Mailing address
PO BOX 100, MATTESON, IL 60443-0100
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0161887464
BCBSIL GROUP NUMBER
—
Enumeration date
10/24/2005
Last updated
11/25/2009
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